ABSTRACT
Background: Child malnutrition is a major public health problem in Ethiopia. Surprisingly; the highest level of stunting is found in food surplus areas of the country. Objective: To identify the determinants of stunting in food surplus areas of West Gojam Zone. Method: A community based cross-sectional survey was conducted on 622 mother-child pairs of 0-59 month old children in Mecha and Wenberma Woredas of West Gojam Zone; Northern Ethiopia between May and June 2006. The study investigated the differential impact of demographic and socio-economic factors; health related factors and dietary factors on stunting among under-five children. Both bivariate analysis and multivariate analysis (logistic regression model) were used to identify the determinants of under-five stunting. Results: The analyses revealed that 43.2 (12.0-17.6) 95CI percent of the children under age five were suffering from chronic malnutrition; 14.8 (39.3-47.1) 95CI percent were acutely malnourished and 49.2 (45.3-53.1) 95CI percent were found to be under-weight. The main contributing factors for under-five stunting were found to be sex of the child; child's age; diarrhea episode; deprivation of colostrum; duration of breastfeeding; pre-lacteal feeds; type of food; age of introduction of complementary feeding and method of feeding. Conclusion: The findings of this study led to the realization that inappropriate feeding practice is the principal risk factor which brought about nutritional deprivation among under-five children in food surplus areas of Ethiopia. Thus; the importance of appropriate feeding during infancy and childhood cannot be overstated even in food surplus areas. The high prevalence of malnutrition in the study area points out the need to revisit the impression held by many people that malnutrition is not a problem in food surplus areas. Development and implementation of preventive policies aimed at addressing child malnutrition should also consider food surplus areas of the country
Subject(s)
Epidemiologic Factors , MalnutritionABSTRACT
Background: Satisfaction is one of the meaningful indicators of patient experience of health care services. Asking patients what they think about the care and treatment they have received is an important step towards improving the quality of care; and to ensuring that local health services are meeting patients' needs. Various studies have reported that satisfied patients are more likely to utilize health services; comply with medical treatment; and continue with the health care provider. Objective: to assess and estimate the perceived levels of satisfaction with health services rendered at government health facilities in selected regions of Ethiopia. Methods: A cross-sectional study that involved an exit interview was conducted in purposively selected government health centers and general hospitals in six regions of Ethiopia. Data were collected using structured questionnaire between June and September 2004. Variables used in the study were grouped and summarized into three components; namely providers' characteristics; services characteristics and cleanliness of the health facilities. Each variable was scored on a 5 point Likert-like scale; ranging from 1 (very dissatisfied) to 5 (very satisfied). The mean score 2.5 is considered as a cut-off point and scores equal and above 2.5 are taken as an indicator of users' perceived satisfaction. Both bivariate and multivariate methods of data analyses were used as deemed necessary. Results: All the three components of investigated variables have reliability coefficients ranging from 0.57 to 0.82. Results of bivariate analyses depicted that the percentage for high mean score satisfaction with health providers' characteristics ranged from 77.25to 93.23; with service characteristics 68.64to 86.48; and satisfaction with cleanliness ranged from 76.50to 90.57. Results of multivariate analysis showed that relatively more explanatory variables were found to be significant ininfluencing cleanliness (cleanliness of waiting place; examination room and medical equipment). Most of the explanatory variables in service characteristics were not statistically significant as compared to other components. Conclusion: The investigators believe that improved service delivery in health facilities could be achieved by to proper and sustainable implementation of the newly initiated civil service reform program in civil service institutionsin the country. Furthermore; periodic assessment of health services and further study; especially from the user's satisfaction perspective is recommended as a fundamental initiative in the improvement of the performance of health facilities